Hard-hitting story: Raising awareness on high school football head injuries

Thursday

Sep 27, 2012 at 7:00 AM

Brandon Streeter began suffering with almost constant headaches

Kent Bush

Brandon Streeter is lucky.

He is dealing with frequent headaches, battling depression, can never wakeboard or even go snowboarding or snow skiing and can't even go to church without enduring pain caused by loud music.

He is lucky.

He isn't dead, paralyzed or comatose. And with 5 serious head injuries in 6 years of football at Rose Hill, he could have suffered any of those fates – his neurologist confirmed that.

The Kansas University School Of Medicine interviewed him about his injury. They are featuring him in their fall issue regarding concussions.

His daily struggle started as a seventh grader when he hit an opponent on a kickoff. It was a big hit. Streeter got dizzy and fell over, losing consciousness for a few seconds.

He recovered and returned to the field and never seemed to miss a beat.

The second event happened when he was a freshman. The third, which happened when he was a sophomore, included trauma that was so serious that Streeter tried to line up as a quarterback for the opposing team.

He sat out a game or two and missed some practice but his skills and competitive desires pushed him back on the field later that year. He had learned what trainers and coaches wanted to hear to keep him from missing time.

Rose Hill uncharacteristically lost its first two games in 2010. As a senior, Streeter was especially motivated in game three at Andale – as tough a place for visitors to win as any.

During the first half, he went to help with a tackle and made helmet-to-helmet contact with his own teammate.

He was knocked out.

But he was on the other side of the field so no one could have known that. He came to the sidelines, mastered the head injury quiz and was cleared.

Coach Greg Slade held Streeter out the rest of the first half so they could get a closer look at him during the intermission.

"We take head injuries pretty seriously," Slade said.

Streeter bluffed his way through the exam and returned to play his best half of the season as the Rockets got their first win.

At the time, that was a big deal to a young man in his senior season of football.

Then, five weeks later, Streeter got dizzy after his head bounced off the artificial turf during a rain-soaked game.

A little later, he jumped to catch a pass over the middle. A Circle defensive back hit him hard from the side.

This time, he didn't get up.

He was unconscious and obviously affected. Coach Slade told him he was finished for that game without any further questions or tests.

That's when the cumulative effects of five known head injuries and dozens of less serious incidents over the years became obvious.

Streeter began suffering with almost constant headaches. The problem was finally bad enough for Streeter to admit to coaches and medical personnel what was going on.

"He finally made the right decision and told us what was happening," Coach Slade said.

His mother, Karen Streeter, said the effects were hard for her to deal with.

"The last one changed his personality completely," she said. "He wouldn't remember conversations. He became very quiet and reserved. It was awful."

Brandon's father Tom, who was a fixture on the sidelines of all of Brandon's games with camera always in hand, said they soon learned that many of his son's problems probably occurred because he never fully recovered from the very first concussion six years ago.

"Brandon went from football to basketball to baseball to off season workouts," Tom said. "He never stopped and the best treatment for this injury is rest. He never took enough time off to recover."

Depression became an issue when the activities that Brandon had thrived on since he was five years old were knocked out of his life.

But Brandon is lucky.

"After a year and a half, he has finally beaten the depression," said Karen Streeter.

Both of his parents have experienced some guilt from hindsight. But concussions aren't like ankle injuries or broken arms. They aren't obvious and you can't put a cast on it and wait for it to heal.

Brandon won't let anyone else take the blame for his condition. He says it is his own fault because he wanted to keep playing so badly, he learned how to make that happen.

"I lied to the coaches, trainers and doctors," Brandon said. "If I gave advice to other players, it would be to tell the doctors the truth and take the time you need to heal."

There is a better way

Brain injuries like concussions aren't as easy to diagnose or treat as joint or bone injuries. They also carry greater risk.

The human brain isn't designed to withstand the pounding football can give.

The skull keeps it from spilling out, but banging against the inside of the skull can cause serious injury to the brain.

Helmets protect the skull from fractures. But concussions occur within the cranium.

Even for doctors, the diagnosis is tricky. Streeter said he knew what to say to get back on the field more quickly. There were no broken bones and only Brandon himself knew if he was truly experiencing headaches or similar issues associated with concussions.

But that is changing.

Circle High School is one of a handful of Kansas High Schools using software programs to track severity of brain injuries.

CHS trainer Brad Jones, who works with Susan B. Allen Hospital, says the new software is integral to protecting athlete safety.

Jones said the online test measures verbal, visual, memory and psycho-motor speed. There is also a 5-minute response test that measures how quickly athletes respond to stimuli. All athletes are tested before their seasons begin to establish a baseline. If Jones suspects a brain injury, he can ask the athlete to retake the test. If there is a significant injury, the test results will show it.

"We had a student who suffered a head injury this year," Jones said. "I went through the sideline test with them and they did fine. Later, they took the online test and it revealed that reaction times were seriously affected."

Without the test, a doctor may have cleared the athlete to play again immediately. With the test, the athlete's health was protected.

For $375, Circle received unlimited testing privileges on the web site. Jones said he thinks that is a small price to pay to protect young athletes.

Jones said that several years ago he had seen a student experience similar problems to those Streeter has endured.

"I blamed myself but the kid's parents wanted him back on the field and a doctor cleared them," Jones said. "I don't think that would have happened if I had access to this test back then."

Tom Streeter said he supports the additional care being taken with head injuries in sports and he hopes they go even further.

"I think a concussion should force a long period of rest," he said. "Maybe even into the next season. I wish we would have known to be more careful with Brandon."

Updated headgear is essential to players' safety

By Josh Prim

El Dorado Times

From 1987 to 2000, protective plastic sporting gear helped contribute to a 40 percent decline in the unintentional injury-related death rate among children in the United States. Innovations in plastics have helped to make essential safety gear – items like plastic helmets are now lighter and stronger and help keep athletes safe.

In contact sports such as football and hockey players are required to wear head gear at all times during play.

A 2011 study by Nationwide Children's Hospital found football players aged 6 to 17 are treated in hospital emergency rooms for about 8,631 concussions each year. Many more concussions may go unreported.

At the professional level, the NFL's helmet sponsor Riddell frequently makes changes to the padding and design of its equipment, while another company Xenith LLC's line of helmets use newer technology with air-filled pads rather than foam. Other companies are testing more dramatic changes to help prevent injuries.

Thermopraxis and Schutt Sports, which is the largest producer of football helmets are developing a product called the Thermocrown.

The product is a bladder that can fit inside a player's helmet. In the event of a hard hit to the head, a trainer would attach a source of cooling gas to the bladder to lower the player's head temperature and stave off damage.

An independent industrial engineer Michael Princip is working on the Bulwark helmet, which features multiple plates on the helmet's exterior, instead of the single-piece design common in today's use. The Bulwark panel system intends to dissipate the force of big hits and reduce the amount of pressure received by any blow to the helmet.

Helmets started as soft, leather caps in the early the 20th century, then gave way to plastic shells with foam padding and facemasks in the 1950s as technology continues to grow so will the safety of players on the field.

Trainer's steps to determine concussion and return to play

By Randy Fisher

Andover American

If it is thought an athlete may have suffered a head injury, the trainers at both Andover and Andover Central high schools tend to look for similar symptoms. Fortunately, there are guidelines and procedures in place from the National Federation of State High School Associations Sports Medicine Advisory Committee to assist them.

According to the NFHS' website, "A concussion is a type of traumatic brain injury that interferes with normal function of the brain. It occurs when the brain is rocked back and forth or twisted inside the skull as a result of a blow to the head or body. What may appear to be only a mild jolt or blow to the head or body can result in a concussion."

Both Pat Moore, with Andover High School, and Jay Hedger, of Andover Central, first look at the mechanism of the injury itself – how it happened. Hedger follows that with subjective information from the athlete.

"Their description of what happened, and any symptoms they are experiencing at the time – whether it be nauseating, vomiting, anything like that; confusion, balance issues," Hedger said.

One of the three areas he looks at is an objective measurement of the athlete's memory.

"Ask questions like do they remember what they had for breakfast this morning, do they remember who they're playing now, do they remember who they played last week, do they remember the score of the game, do they remember their date of birth," Hedger said. "Just kind of get an idea if they have some memory issues."

Having them recite the months of the year or a series of numbers in reverse will test their cognitive abilities, Hedger said. He also administers the Balance Error Scoring System (BESS) that checks three different types of stances to see if their balance is impaired.

When the athlete comes off the field or the court, Moore will observe their personality, which will change dramatically with a concussion.

"It can be emotional from laughing to crying," he said. "Each kid could have a little different symptom."

Some of the more common symptoms are being very quiet, sick to their stomach, eyes dilated or changed out, nausea, humming in their ears and seeing stars.

The bottom line is to determine if the athlete may have suffered a concussion. When that happens, KSHSAA protocol is for the athlete to be kept out the rest of the game or practice.

Hedger said if there is any loss of consciousness, even briefly, he assumes there is a neck injury and 911 is contacted. However, loss of consciousness cannot be the overriding factor that a person has suffered a concussion. The NFHS says that less than 10 percent of players actually lose consciousness with a concussion.

Even after a doctor examines and releases an athlete who suffered a concussion, the KSHSAA requires a five-step Progressive Physical Activity Program before a concussed athlete can resume playing. The steps are, in chronological order: light aerobic exercise, moderate aerobic exercise, noncontact training drills in full uniform, full contact practice or training, and full game play.

These steps are important because if the athlete is not fully recovered, concussion symptoms may not show up under normal physical conditions.

"Operating temperatures, blood pressure up, running and breathing and stuff – sometimes you don't catch the headache again until you do all this," Moore said.